Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
2021
July 31, 2020
Premium$42PCP$15Specialist$50Referrals RequiredNoInpatient Hospital$390 (days 1-5) ; $0 (days 6-90)MOOP In-network$6,700 Rx Deductible​$250 tiers 3-5Rx Preferred$5/$12/$47/$100/28%Key Extra BenefitsVision, Hearing, Fitness, OTC $25/Quarter for select health and wellness continue reading
July 31, 2020
Premium$0PCP$5Specialist$40Referrals RequiredNoInpatient Hospital$350 (days 1-5) ; $0 (days 6-90)MOOP In-network$7,550 Rx DeductibleN/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $25/Quarter for select health and wellness products, continue reading
July 31, 2020
Premium$0PCP$5Specialist$35Referrals RequiredNoInpatient Hospital$298 (days 1-7) ; $0 (days 8-90)MOOP In-network$7,550 Rx DeductibleN/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $50/Quarter for select health and wellness products, continue reading
July 31, 2020
Premium$0PCP$0Specialist$40Referrals RequiredNoInpatient Hospital$345 (days 1-5) ; $0 (days 6-90)MOOP In-network$7,550 Rx DeductibleN/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $50/Quarter for select health and wellness products, continue reading
July 31, 2020
Premium$0PCP$0Specialist$30Referrals RequiredNoInpatient Hospital$298 (days 1-7) ; $0 (days 8-90)MOOP In-network$7,550 Rx DeductibleN/ARx Preferred$4/$12/$47/$100/33%Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC $75/Quarter for select health and wellness products, continue reading
July 31, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
July 31, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
July 31, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
July 31, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
July 31, 2020
Premium ​ PCP ​ Specialist ​ Referrals Required ​ Inpatient Hospital ​ MOOP In-network ​ Rx Deductible ​ Rx Preferred ​ Key Extra Benefits ​ Market continue reading
July 31, 2020
Dental $2500 annually; $0 copayments covers: exams, x-rays, cleanings, fillings, crowns, extractions, dentures Healthy Foods Card N/A Vision Annual exam and $300 credit every year for continue reading
Page [tcb_pagination_current_page] of [tcb_pagination_total_pages]